The Application

The following applications can be downloaded and printed:

English Application for Healthy Kids

Spanish Application for Healthy Kids

If you would like to request an application be sent to you, please click here.

If you need help filling out the application there are many people who can help you.

• Call our office to get help over the phone (1-877-464-2447)
• Visit our office for help in person
• Click for directions
• Visit one of our application assistance sites for help in person
• Call for a list of sites in your area (1-877-464-2447)

The Application Steps:

1. Fill out the application and sign it on the back
2. Submit copies (not the originals) of all the documents listed on the checklist
3. Mail the application to:

   1 Pillsbury Street, Suite 300
   Concord, NH 03301